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General NPI Number Information
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NPI Number | 1942255195
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Entity Type | Organization
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Legal Business Name | FAMILY CARE SPECIALISTS MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 1701 E CESAR CHAVEZ AVENUE SUITE 230
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City | LOS ANGELES
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State | CA
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Zip | 90033-2464
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Country | US
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Telephone | 323-226-1100
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Fax | 323-226-1101
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Provider Business Mailing Address
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Address Line | 5823 YORK BLVD STE 3
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City | LOS ANGELES
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State | CA
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Zip | 90042-2634
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Country | US
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Telephone | 323-255-5643
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Fax | 323-255-2158
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Authorized Official
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Title or Position | MEDICAL GROUP DIRECTOR
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Name | MAURICIO EDUARDO BUENO
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Credential |
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Telephone | 323-317-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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